the State has established for providing child health assistance to targeted low-income children under the plan and otherwise for maximizing health benefits coverage for other low-income children and children generally in the State.

(2) Strategic objectives

Such plan shall identify specific strategic objectives relating to increasing the extent of creditable health coverage among targeted low-income children and other low-income children.

(3) Performance goals

Such plan shall specify one or more performance goals for each such strategic objective so identified.

(4) Performance measures

Such plan shall describe how performance under the plan will be—

(A)measured through objective, independently verifiable means, and

(B)compared against performance goals, in order to determine the State’s performance under this subchapter.

(b) Records, reports, audits, and evaluation

(1) Data collection, records, and reports

A State child health plan shall include an assurance that the State will collect the data, maintain the records, and furnish the reports to the Secretary, at the times and in the standardized format the Secretary may require in order to enable the Secretary to monitor State program administration and compliance and to evaluate and compare the effectiveness of State plans under this subchapter.

(2) State assessment and study

A State child health plan shall include a description of the State’s plan for the annual assessments and reports under section
1397hh(a) of this title and the evaluation required by section
1397hh(b) of this title.

(3) Audits

A State child health plan shall include an assurance that the State will afford the Secretary access to any records or information relating to the plan for the purposes of review or audit.

(c) Program development process

A State child health plan shall include a description of the process used to involve the public in the design and implementation of the plan and the method for ensuring ongoing public involvement.

(d) Program budget

A State child health plan shall include a description of the budget for the plan. The description shall be updated periodically as necessary and shall include details on the planned use of funds and the sources of the non-Federal share of plan expenditures, including any requirements for cost-sharing by beneficiaries.

(e) Application of certain general provisions

The following sections of this chapter shall apply to States under this subchapter in the same manner as they apply to a State under subchapter XIX of this chapter:

(1) Subchapter XIX provisions

(A)Section
1396a(a)(4)(C) of this title (relating to conflict of interest standards).

(B)Section
1396a(a)(72) of this title (relating to limiting FQHC contracting for provision of dental services).

(C)Section
1396a(a)(73) of this title (relating to requiring certain States to seek advice from designees of Indian Health Programs and Urban Indian Organizations).

(D)Subsections (a)(77) and (kk) ofsection
1396a of this title (relating to provider and supplier screening, oversight, and reporting requirements).

(E)Section
1396a(e)(13) of this title (relating to the State option to rely on findings from an Express Lane agency to help evaluate a child’s eligibility for medical assistance).

(F)Section
1396a(e)(14) of this title (relating to income determined using modified adjusted gross income and household income).

(G)Section
1396a(bb) of this title (relating to payment for services provided by Federally-qualified health centers and rural health clinics).

(H)Section
1396a(ff) of this title (relating to disregard of certain property for purposes of making eligibility determinations).

(I)Paragraphs (2), (16), and (17) of section
1396b(i) of this title (relating to limitations on payment).

(J)Paragraph (4) of section
1396b(v) of this title (relating to optional coverage of categories of lawfully residing immigrant children or pregnant women), but only if the State has elected to apply such paragraph with respect to such category of children or pregnant women under subchapter XIX.

(K)Section
1396b(w) of this title (relating to limitations on provider taxes and donations).

(L)Section
1396r–1a of this title (relating to presumptive eligibility for children).

(1)The Secretary may not approve a waiver, experimental, pilot, or demonstration project that would allow funds made available under this subchapter to be used to provide child health assistance or other health benefits coverage to a nonpregnant childless adult or a parent (as defined in section
1397kk(c)(2)(A) of this title), who is not pregnant, of a targeted low-income child.

(2)The Secretary may not approve, extend, renew, or amend a waiver, experimental, pilot, or demonstration project with respect to a State after February 4, 2009, that would waive or modify the requirements of section
1397kk of this title.

Subsec. (f). Pub. L. 111–3, § 112(a)(2)(A)(i), substituted “section
1315(a) of this title:” for “section
1315(a) of this title, the Secretary” and inserted par. (1) designation and “The Secretary” before “may not approve a waiver,”.

Subsec. (f)(1). Pub. L. 111–3, § 112(a)(2)(A)(ii), (iii), inserted “or a parent (as defined in section
1397kk(c)(2)(A) of this title), who is not pregnant, of a targeted low-income child” after “nonpregnant childless adult” and struck out last sentence which read as follows: “For purposes of the preceding sentence, a caretaker relative (as such term is defined for purposes of carrying out section
1396u–1 of this title) shall not be considered a childless adult.”

Except as otherwise provided, amendment by Pub. L. 111–3effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, see section 3 ofPub. L. 111–3, set out as a note under section
1396 of this title.

Amendment by section 203(a)(2), (d)(2) ofPub. L. 111–3effective Feb. 4, 2009, see section 203(f) ofPub. L. 111–3, set out as a note under section
1396a of this title.

Amendment by section 501(d)(2) ofPub. L. 111–3effective Jan. 1, 2009, see section 501(d)(3) ofPub. L. 111–3, set out as a note under section
1396a of this title.

Pub. L. 109–171, title VI, § 6102(d),Feb. 8, 2006, 120 Stat. 132, provided that: “This section [amending this section and section
1397ee of this title and enacting provisions set out as a note below] and the amendments made by this section shall take effect as if enacted on October 1, 2005, and shall apply to any waiver, experimental, pilot, or demonstration project that is approved on or after that date.”

Rule of Construction

Pub. L. 109–171, title VI, § 6102(c),Feb. 8, 2006, 120 Stat. 131, as amended by Pub. L. 111–3, title I, § 112(a)(2)(B),Feb. 4, 2009, 123 Stat. 33, provided that: “Subject to section 2111 of the Social Security Act [42 U.S.C. 1397kk], as added by section 112 of the Children’s Health Insurance Program Reauthorization Act of 2009 [Pub. L. 111–3], nothing in this section [amending this section and section
1397ee of this title and enacting provisions set out as a note above] or the amendments made by this section shall be construed to—

“(1) authorize the waiver of any provision of title XIX or XXI of the Social Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.) that is not otherwise authorized to be waived under such titles or under title XI of such Act (42 U.S.C. 1301 et seq.) as of the date of enactment of this Act [Feb. 8, 2006];

“(2) imply congressional approval of any waiver, experimental, pilot, or demonstration project affecting funds made available under the State children’s health insurance program under title XXI of the Social Security Act (42 U.S.C. 1397aa et. seq.) or any amendment to such a waiver or project that has been approved as of such date of enactment; or

“(3) apply to any waiver, experimental, pilot, or demonstration project that would allow funds made available under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) to be used to provide child health assistance or other health benefits coverage to a nonpregnant childless adult that is approved before the date of enactment of this Act or to any extension, renewal, or amendment of such a waiver or project that is approved on or after such date of enactment.”

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